COLLECTIVE BARGAINING: TX Senate OKs Practice for Docs
The Texas Senate passed a bill by voice vote Wednesday that would allow independent doctors and groups to collectively bargain with health plans. "The whole intent of this bill was to give doctors the right to exchange information and to be able to communicate about the ultimate affects of a contract offer," said sponsor state Sen. Chris Harris (R). The proposed law would exempt certain doctor alliances from antitrust laws, and allow doctors to communicate among themselves while negotiating (Lunday, Ft. Worth Star-Telegram, 4/29). The bill would restrict doctors' ability to organize; no matter what the outcome of a negotiation with a health plan, doctors could never strike or boycott. An individual physicians' group could not account for more than 10% of the market, and the state attorney general would be granted broad powers to oversee bargaining. "Doctors could negotiate with health plans about the drugs they prescribe their patients, the appeals system for denied treatments and control of patient medical records" (Ornstein, Dallas Morning News, 4/29). Physicians could not jointly negotiate fees unless the health plan in question held significant market share, as determined by the attorney general (Star-Telegram, 4/29).
Business and insurance groups denounced the bill for what they said would be an adverse impact on health costs. Richard Evans, lobbyist for the Texas Association of Business and Chambers of Commerce, said, "I hope the Texas House will ask some of the hard questions about cost. Clearly, these doctors are going to negotiate for higher fees and that means our costs are going to go up and fewer people are going to be able to afford health care." Some legal scholars said the bill, which if passed would be the first of its kind in the nation, might set a bad precedent. Toby Singer, former official at the FTC, said, "In general, antitrust exemptions for specific industries are a bad idea." But, she conceded, "In markets where there are only a few health plans, the health plans clearly have more power than the doctors." Kim Ross, the Texas Medical Association's chief lobbyist, said, "We'll finally have an impartial referee with the legal authority to halt some of the more predatory abuses that are occurring in physician negotiations (Morning News, 4/29).